A new research report from UNH’s Institute on Disability (IOD), commissioned by the New Hampshire Bureau of Behavioral Health (BBH), documents some of the strengths and challenges of New Hampshire’s community mental health service system and reflects the critical issues that need to be addressed in N.H.’s system reform efforts. The report, “New Hampshire Public Mental Health Consumer Survey Project, Summary of Findings 2011,” provides the third year of data based on consumer ratings of New Hampshire’s 10 regional community mental health centers (CMHCs).

The random survey, of adults, youth, and family members of consumers of the state’s CMCHs, assessed general satisfaction levels with services, access to services, participation in treatment, quality of treatment received, cultural sensitivity, and treatment outcomes. Results from the survey highlight the need for greater engagement on multiple levels:

A majority of consumers were able to access needed services, (75 percent of adults, 64 percent of families, and 69 percent of youth) and most felt they were participants in their care (72 percent, 85 percent, and 74 percent). However, only a third of adults (30 percent) participated with their local peer support agency sometimes or often to receive additional one-on-one and group supports.

Regarding families and awareness of substance use, 12 percent of youth surveyed admitted to having a drug or alcohol problem, only four percent of parents or guardians thought their children had substance use issues.

At the community level, social isolation among adult consumers at CMHCs continued to be high (only 56 percent of adults felt they belonged in their community), as were unemployment rates (82 percent) and the number of adults living at or near the poverty level (73 percent earned under $15,000 per year).

Concerning school networks and their impact on mental health, nearly one in five students had been suspended or expelled from school in the past two years. Similar proportions were found among all age groups: youth ages 13-17, children ages 9-12, and children under 9 years.

Regarding services provided by the CMHCs, while most consumers were satisfied with the services they received (77 percent of adults, 72 percent of families, and 73 percent of youth), there was substantially less agreement on the extent to which their lives have been improved as a direct result of services (62 percent, 58 percent, and 59 percent).

“We're at an important juncture," says Peter Antal, IOD researcher and author of the report. "With steady cuts in services across the state, as well as substantial cuts in CMHC budgets even as consumer demand is rising, it is increasingly vital that we recognize and address the multiple factors that contribute to mental health. Management of and recovery from mental illness is a challenge that needs to be directly, honestly, and compassionately faced by individuals, families, community members, service providers, and the State of New Hampshire -- each has a role."

"The results of the survey highlight the strengths of our current system as well as the need to implement a new financing and service model for community mental health services to better support a quality driven system," says Erik Riera, administrator of the Bureau of Behavioral Health. Riera adds that the Payment and System Reform waiver (http://behavioralhealthreform.com/home), a 1915(b) waiver application to the Centers for Medicare and Medicaid Services, will be structured to support and build upon the strengths of the current system and address the different areas needing improvement in New Hampshire.

The Public Mental Health Consumer Survey Project, funded by a grant from the Substance Abuse and Mental Health Services Administration, is a joint initiative among the Institute on Disability, the UNH Survey Center, the Bureau of Behavioral Health, and New Hampshire’s 10 CMHCs. For more information, visit www.iod.unh.edu/pmhs.

The Bureau of Behavioral Health (BBH) is the state mental health authority, responsible for overseeing the community mental health system in N.H. BBH seeks to promote respect, recovery, and full community inclusion for adults who experience a mental illness and children with an emotional disturbance. BBH works to ensure the provision of efficient and effective services to those citizens who are most severely and persistently disabled by mental, emotional, and behavioral dysfunction.

The Institute on Disability at UNH was established in 1987 to provide a coherent university-based focus for the improvement of knowledge, policies, and practices related to the lives of persons with disabilities and their families. Its mission is to strengthen communities to ensure full access, equal opportunities, and participation for all persons.